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Article
Interaction of Two Variants of IL4 Receptor-Α Gene with Serum IgE Level and Some Risk Factors for Childhood Asthma in Karbala Governorate

Author: Ali Mansoor Al-Ameri علي منصور
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1744-1759
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Asthma and related allergic diseases are complex genetic diseases with major environmental influences that occur in a developmental context. Susceptibility to asthma is influenced by genes and environment; implicated genes may indicate pathways for therapeutic intervention.Aim: The present study aims to test the linkage association of IL-4Ra gene polymorphisms, E375A and C406R, determined by PCR/RFLP assay, with asthma development from 100 asthmatic children. In addition to their association with elevated serum IgE level in asthmatic children and possible interaction with other contributing factors including high BMI, history of prematurity, neonatal jaundice or vitamin D deficiency, exposure to bottle feeding and family history of atopy and/or asthma. Patients and methods: This is a cross sectional survey study done in Kerbala Pediatric teaching Hospital during April, 2011 through February, 2013. Results & Discussion: Data of the current study suggested a significant linkage association between IL4RA single nucleotide polymorphisms, SNPs, (E375A and C406R) and development of childhood asthma in the recruited participants, r= 0.82 and 0.67, respectively. Interestingly, the latter effect is synergistically increased upon gene-environment interaction with any of the studied risk factors tested in this study, except past history of neonatal jaundice.The presence of E375A and C406R SNPs of IL4RA gene have potential effect on development of childhood asthma. Secondly, this effect is synergistically reinforced via gene-environment interaction of these SNPs with other asthma contributors including high BMI, history of prematurity, formula feeding, vitamin D deficiency and positive family history of asthma.Conclusion: Our study reinforced the theory that asthma is a multifactorial disease suggesting a noticeable interaction between genetic and environmental factors in the development of this disease.


Article
The Effect of Postural Changes on Spirometric Indices of Upper Airway Obstruction

Authors: Ali Mansoor Al-Ameri --- Ahmad Jumah Mhows --- Mudhaffar Sami Khazaál,
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 2 Pages: 1608-1614
Publisher: Kerbala University جامعة كربلاء

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Abstract

the spirometric diagnosis of upper airway obstruction is an important non-invasivetechnique that was validated for the diagnosis of such lesions relying on severalindices that were derived from the flow volume loops of patients.Objectives: Is to find out if postural changes have an effect on spirometric indices of airwayobstruction in healthy subjects and if so, does this merit performing the test in supineposture?Subjects and methods: This study conducted in the department of physiology and medicalphysics/ Kerbala medical college, in which 17 males aged from 18-19 years (18.53 ± 0.51),had BMI of (22.95 ± 2.11 Kg/M2 ), heights of (1.75 ± 0.14 meters) and weights of (70.32 ±6.34 Kgs) were enrolled. The following spirometric data were measured in two different bodypositions (erect versus supine): Forced vital capacity (FVC), Forced inspiratory flow at 50%of vital capacity (FIF50%), Forced expiratory flow at 50% of vital capacity (FEF50%), Forcedexpiratory volume in first second (FEV1), Forced expiratory volume in first 0.5 second (FEV0.5), Peak inspiratory flow (PIF) and Peak expiratory flow (PEF). From these data, thefollowing indices of upper airway obstruction were derived: (FEV1/ FEV0.5, FEV1/ PEF,FEF50%/ FIF50%, and PEF/PIF). These indices were compared with each other in respect totwo body positions.Results:1- All the measured inspiratory and expiratory flow rates were significantly lower in supineposition (p < 0.05).2- Of the four measured indices of upper airway obstruction, only the FEV1/PEF ratioincreased significantly (p < 0.05) by about 27% upon reclining.

Keywords

PFT --- UAO --- FVL --- Body posture --- and OSAS.


Article
A study of cytokine profile and serum IgE level and their association with montelukast therapy in childhood asthma

Authors: Munther Hussain Al-Kadhimy --- Jaafar Kadhim Naama --- Ali Mansoor Al-Ameri
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 1 Pages: 1573-1583
Publisher: Kerbala University جامعة كربلاء

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Abstract

asthma is the most common allergic disease giving rise to the morbidity or schoolabsence in children and has an increasing incidence worldwide. Montelukast is a wellknown leukotriene receptor antagonist used to treat children with asthma. Severalcytokines in addition to IgE are known to affect the course of the disease and response totreatment in this regard.This is a prospective placebo-controlled cohort study done in Kerbala Pediatric TeachingHospital during April, 2011 through February, 2013. It aims to test the effect of cytokineprofile and serum IgE level (measured by ELISA) on asthma development and their influenceon 1-month course of montelukast therapy compared to a placebo group (30 patients each).Of the 60 patients, 30 were given montelukast as add-on therapy and the other 30 wereregarded as placebo group. Serum level of IL2, 4, 10, 17 and IFN-gamma were determinedpre- and post- treatment course in all patients and compared with 30 healthy controls.Response was assessed according to answer to a pre- formed questionnaire formula answeredby the parents regarding frequency and severity of wheezy attacks.Results showed a significantly higher level of serum IL4 in asthmatic children than in healthycontrol. More importantly, its level was shown to be directly related with poorer clinicalresponse to montelukast, p value < 0.05. In addition, montelukast was shown to significantlydecrease serum IL4 level in the treatment group (30 asthmatics) compared to the placebogroup, p value <0.05.Furthermore, our data revealed that the serum level of IL10 was significantly lower inasthmatics compared to the control healthy children and that the higher the level of IL10, thebetter the clinical response to montelukast (r=0.73). While the role of the other cytokinestested in this study, IL 2, IL 17 and IFN-gamma was non-significant regarding associationwith disease or influence on response to montelukast.Data regarding serum IgE level in the recruited 60 asthmatic children revealed that there is asignificantly increased level compared to the healthy control group, p value < 0.05.Additionally its serum level negatively correlates with clinical response to montelukast, r=0.58.In conclusion, serum level of IgE, IL4 and IL10 are important markers associated withchildhood asthma development and influencing response to montelukast. Secondly, it wasshown that montelukast add-on therapy has significantly better biochemical and clinicalresponse in childhood asthma than conventional asthma controllers alone.

Keywords


Article
A Study of Some Immunological Markers in Patients with Chronic Kidney Disease in Kerbala

Authors: Ali Mansoor Al-Ameri --- Hasanain salah jaafar2 --- Reyadh Hneawa2 --- Weaam Awad Al-Muhana*
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 2 Pages: 1878-1884
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Chronic kidney disease (CKD) is a progressive loss in renal functionover a period of months or years.Immune status of patients with CKD represents a fruitful area of research world-wide. Many hypotheses were mounted in this regards and most of them based on levels of certain immunological markers.Aim: To evaluate the serum levels of some immunologic markers in patients with CKD and to predict their correlation with the disease severity.Study design and objective: This is a cross sectional survey study. It was performed during December, 2013 through April, 2014at Al-Hussein Medical City, Holly Kerbala.Method: A total of 60 doctor-diagnosed patients with chronic kidney diseases for different causes and in variable stages of the disease. Their gender distribution and age range were (39 women; 30-62 years and 21 men; 33-70 years). Other 20 healthy persons were chosen as control group. An informed consent was taken from all the participants submitted to the study. Age, gender and presence of diabetes or hypertension were recorded. Then, 3-ml venous blood sample was taken from each participant and sera were isolated via centrifuge. The serum levels of the following markers were determined using ELISA; haptoglobin, alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, alpha-2-macroglobulin (A2M) and the complement proteins C3 and C4.Results: Serum levels of all studied immunologic markers were significantly lower in patients with CKD than those in the control subjects, p value < 0.05. An exclusion is the non significant rise in serum level of haptoglobin and alpha-2-macroglobulinnoticed in CKD stages other than ESRD.In addition, serum levels ofhaptoglobin, A2M, IgA and IgM are significantly lower in ESRD than other stages of CKD (p value < 0.05), while levels of C3 and C4 are significantly lower in moderate CKD than other stages of renal impairment included in this study (p value < 0.05).Discussion: It is well known that the CKD patients suffer significant immune compromization. Our data revealed down regulation of certain immunological parameters in their sera such as alpha1 anti-trypsin, immunoglobulin-A (IgA), IgG, IgM, and the complement proteins C3 and C4.This could explain the susceptibility to infection and abnormally delayed wound healing accompanying CKD.Conclusion: It was concluded that serum levels of all studied immunologic markers, excepthaptoglobin and alpha-2-macroglobulin,were significantly lower in patients with CKD than those in the healthysubjects. Furthermore, this is not associated with the presence or absence of diabetes and/or hypertension. This finding could, in part, prove that the immune deficiency status in these patients is purely due to their impaired renal functions. Key words: immunologic markers, chronic kidney disease.

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